TEMP BPO Associate

• The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc. providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

• The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

PRIMARY DUTIES AND RESPONSIBILITIES:

1. Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.

2. Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.

3. Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).

4. Identify and elevate clinical inquiries to the pharmacist team as appropriate.